JPH0698150B2 - Electric scalpel - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electric scalpel mainly used for endoscopic surgery.

[0002]

2. Description of the Related Art As an electrode of an electric knife, a knife type electrode, a ball type electrode having a spherical tip, and a bipolar or monopolar tweezers type electrode are used.
Knife-shaped electrodes coagulate and cut tissue. The ball-shaped electrode can energize and coagulate tissue. The tweezers type electrode can coagulate by sandwiching the tissue.
Knife type or ball type electrodes can be used for endoscopic surgery, but tweezers type electrodes cannot be used. The tweezers-type electrode is mainly used in brain surgery, but cannot be used in endoscopic surgery. This is because it is not possible to insert the sleeve through the skin to reliably grasp the tissue inside the body.

[0003]

Knife-type and ball-type electrodes can be used for endoscopic surgery, but they cannot coagulate by sandwiching tissue. Also, the coagulated tissue cannot be expanded. An electrode that can grasp and coagulate tissue has the feature of effectively stopping hemostasis. In order to realize this, the gripping forceps type electrode 1 shown in FIG. 1 is used. The gripping forceps type electrode 1 is connected to the pipe 2 by protruding from the grip to the tip. The tip portion of the pipe 2 is shown in FIG. The gripping forceps type electrode 1 shown in this figure is
A rod-shaped base 3 protruding from the tip of the pipe 2 is fixed, and two sandwiching pieces 4 are connected to the base 3 so as to be opened and closed as shown in FIGS. An elastic pressing rod 5 is connected to open and close the sandwiching piece 4. The elastic pressing rod 5 has a rear end inserted into the pipe 2 and connected to the shaft 6, and a front end branched into two to be connected to the sandwiching piece 4. The rear end of the shaft 6 is connected to the grip 7 as shown in FIG. When the grip 7 is grasped, the shaft 6 is pushed out, and the shaft 6 pushes out the elastic pressing rod 5 to close the elastic pressing rod 5 or the sandwiching piece 4 as shown in FIG. When the grip 7 is loosened, the shaft 6 is pulled, and the sandwiching piece 4 is expanded as shown in FIG. The grasping forceps type electrode 1 of this structure can coagulate by energizing the tissue by sandwiching the tissue with the sandwiching piece 4. Therefore, hemostasis can be effectively stopped. However, the electrode 1 of this structure has an elastic pressing rod 5 that slides in the axial direction at the tip.
And the sandwiching piece 4 that opens and closes, there is a drawback that the insulated portion at the tip becomes long. In other words, the local part of the tip cannot be an insulated part in an extremely narrow area. This is because it is almost impossible to insulate the sliding and moving parts. If the sliding portion is covered with an insulating material, it is difficult to smoothly slide, and occasionally, if the insulating film is peeled off by sliding, there is a risk of electric leakage. The electrode 1 having a long insulated portion cannot accurately energize the targeted local area of the tissue. This is because a large area to be insulated contacts the tissue. Therefore, the gripping forceps-type electrode can coagulate by sandwiching the tissue, but has a drawback that the targeted local portion of the tissue cannot be coagulated accurately. Further, in the electrode 1 having this structure, since the shaft 6 is inserted into the pipe 2, the pipe 2 has a drawback that it cannot be bent, and the tip portion cannot be gently curved to be formed into a shape easy to use.

The present invention was developed for the purpose of solving the drawbacks of the conventional electric scalpels. An important object of the present invention is that it can be used for endoscopic surgery.
It is an object of the present invention to provide an electric scalpel that can accurately pinch a targeted local area and can be used for coagulation and exfoliation of tissue to shorten the operation time and reduce the burden on the patient.

Another important object of the present invention is to provide an electric scalpel which can minimize extra tissue damage and which can be used easily and conveniently by the operator in a familiar shape.

[0006]

In order to achieve the above-mentioned object, the device of the present invention has the following constitution. That is,
The electric scalpel of the present invention includes a grasping forceps-type electrode 1 for energizing human body tissue, a sleeve 8 having an inner diameter for inserting the electrode 1, penetrating the skin of a patient, and a lead wire 9 for the electrode 1. And a power supply 10 to be connected.

Further, in the electric knife of the present invention, the electrode 1 is of scissor type. The scissors-type electrode 1 is covered with an insulating film 12 on the surface of the portion excluding the tip portion and the sliding portion connected by the pin 11. Further, the sleeve 8 through which the electrode 1 is inserted is formed in a cylindrical shape with an insulating material in order to insulate the human body from the scissors-shaped electrode 1 with this.
The scissors-type electrode 1 is used by insulating the sliding portion with a sleeve 8 inserted into the skin of the human body and energizing human tissue at the insulated portion at the tip.

[0008]

In the electric knife of the present invention, the lead wire 9 is connected to the scissors type electrode 1. The lead wire 9 is connected to the power supply 10.
One electrode 1 of the power supply 10 is connected to the human body, for example, the thigh, via another lead wire 9. The scissors-type electrode 1 is inserted into the sleeve 8 which penetrates the skin of the human body. Sleeve 8
Isolates the sliding portion connected by the pin 11 in the middle of the scissors type electrode 1. In this state, when the human body tissue is sandwiched by the non-insulating portion at the tip of the scissors-type electrode 1 and the current is applied, the tissue can be coagulated. Furthermore, the scissors-type electrode 1 can also exfoliate the tissue without energization.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. However, the examples shown below exemplify an electric knife for embodying the technical idea of the present invention,
The electric knife of the present invention does not specify the material, shape, structure, and arrangement of the constituent parts to the following structures. The electric knife of the present invention can be modified in various ways within the scope of the claims.

Further, in this specification, for easy understanding of the claims, the numbers corresponding to the members shown in the embodiments are referred to as "claims column", "action column", and "action column". It is added to the members shown in the section of "Means for Solving the Problems". However, the members shown in the claims are
It is by no means specific to the members of the examples.

The electric knife shown in FIG. 4 has a gripping forceps-type electrode 1 for energizing human tissue, a sleeve 8 having an inner diameter for inserting the electrode 1 and penetrating the skin of a patient, and the electrode 1. A power supply 10 connected via a lead wire 9.

The electrode 1 is shown in FIG. The electrode 1 shown in this figure is an elongated scissor type electrode 1. The scissors-type electrode 1 connects the middle of two elongated metal rods with a pin 11 so as to be opened and closed. The grip 13 at the rear end of the rod has a loop shape into which a finger can be inserted. The tip is gradually tapered and is gently curved as shown in FIG. The scissors-shaped electrode 1 having this shape has a feature that it is easily pinched by the curved tip. The scissors-type electrode 1 has, for example, a total length of 15 so that it can be inserted into the body through the sleeve 8.
It is designed in the range of cm to 45 cm, preferably 18 cm to 35 cm.

The scissors-type electrode 1 is covered with an insulating film 12 on its surface excluding the tip and the sliding portion connected by the pin 11. For the insulating film 12, synthetic resin such as silicone resin, epoxy resin, polyvinyl chloride resin, urethane resin, fluororesin, natural or synthetic rubber, or insulating varnish can be used. The insulating film 12 has scissors-type electrodes 1
It is possible to use those having a volume resistivity of 10 ¹⁰ Ω · cm or more at room temperature, which can be attached to the surface of Silicon resin has an extremely high dielectric strength of 56 to 88 kV / mm,
There is a feature that the insulation film 12 can be made thin to prevent dielectric breakdown. Also, the dielectric strength of natural soft rubber is 30-50 kV /
mm, butadiene-styrene soft rubber has a dielectric strength of 3
It is considerably large as 0 to 40 kV / mm, and these insulating films 12 have the feature that the film thickness can be made thin and the dielectric breakdown voltage can be increased.

The insulating film 12 is attached to the entire surface of the scissors type electrode 1 in a disassembled state. The insulating film 12 is removed from the tip of the scissors type electrode 1 and the sliding portion. In the sliding part, two rods are pinned by the pins 11 and the tip of the scissors-type electrode 1 sandwiches human tissue, and current is applied to solidify. The length of the portion where the insulating film 12 at the tip is removed, that is, the non-insulating portion 14 is usually 1
mm to 15 mm, preferably 1 mm to 10 mm, and the optimum value is designed in the range of 1.5 to 6 mm. If the total length of the non-insulating portion 14 at the tip is too long, the area in contact with human tissue becomes large, and it is not possible to accurately pinch the local portion to be solidified. On the other hand, if the non-insulating portion 14 is too short, the contact area with the tissue is narrowed and the region where the tissue can be coagulated is narrowed.

Since the tip of the scissors type electrode 1 energizes by sandwiching the human body tissue, as shown in FIG. 7, the inner insulating film 12 which is the sandwiching surface is removed to form the non-insulating portion 14. However, although not shown, the scissor-type electrode 1 can be made into the non-insulating portion 14 by removing the insulating film 12 inside and outside the tip.

Further, the scissors-type electrode 1 is provided with a connection terminal 15 for the lead wire 9 at the grip portion. The connection terminal 15 is provided inside the grip so as to project rearward. The cross-sectional shape of the connection terminal 15 is shown in FIG. Connection terminal 1 shown in this figure
No. 5 has a metal rod provided with protrusions, and an insulating pipe 16 is fixed to the outer periphery thereof. The insulating coating 12 is removed from the protrusion, and a connection jack (not shown) of the lead wire 9 is inserted therein to be connected.

Further, in the scissors-type electrode 1 shown in FIG. 5, the arm 17 is projected so as to face the inside of the grip. One of the two arms 17 is long and the other is short. As shown in FIG. 9, the two arms 17 wrap each other when grasping the grip to stop the scissor-type electrode 1 at a fixed position. Therefore, the two arms 17 are provided on the metal rod by being vertically displaced in FIG. 9, and when they are wrapped with each other, the contact surfaces are uneven and are difficult to slip.

The sleeve 8 is cylindrical and has a collar at one end. The sleeve 8 insulates the sliding portion connected by the pin 11 of the scissors-type electrode 1 and prevents this portion from electrically contacting the skin. Therefore, the sleeve 8 is made of an insulating material having a volume resistivity of 10 ¹⁰ Ω · cm or more at room temperature,
For example, silicone resin, polyvinyl chloride resin, polyethylene resin, polystyrene resin, fluorine resin, synthetic resin such as ebonite, ceramic materials such as steatite, titanium oxide, glass, hard or semi-hard natural or synthetic rubber can be used. .

The sleeve 8 is slightly larger than the outer width of the sliding portion connected by the pin 11 of the scissor type electrode 1 so that the scissor type electrode 1 can be opened and closed by inserting the sleeve 8 therein, for example, the inner diameter is 8 mm to 25 mm. , Preferably 8 mm to 18 mm, and formed into a cylindrical shape. The sleeve 8 penetrates the skin and guides the tip of the scissors-type electrode 1 inserted thereinto into the abdominal cavity, for example, 3 cm to 10 cm, preferably 4 cm.
It is designed in the range of 9 cm to 9 cm.

The power supply 10 has two output terminals, one of which is connected to the scissors-type electrode 1 and the other of which is connected to the surface of the patient's body, for example, a thigh, via a lead wire 9. The power source 10 depends on the usage state of the scissors type electrode 1,
A mode change switch 18 for adjusting the output waveform and an output adjusting dial 19 are provided. Mode switch 18
Switches the output to three modes: coagulation, mixing, and incision. Coagulation is a mode used when hemostasis of a limited site is strongly performed, and high frequency is output in a pulsed manner at a constant cycle. Mixing blends the coagulation ability into the incision at an arbitrary ratio, and increases the duty of the high frequency output as compared with the coagulation mode. The incision continuously outputs a high frequency to effectively incise the tissue.

FIG. 10 shows output waveforms in the coagulation, mixing, and incision modes. In these figures, the high frequency is usually designed in the range of 200 kHz to 700 kHz, preferably 300 kHz to 600 kHz. Further, the repetition frequency output in pulse in the coagulation and mixed mode, that is, the frequency for modulating a high frequency, is 5 kHz to 100 kHz, preferably 10 kHz to
It is designed to 80 kHz.

The power supply 10 converts the commercial power supply 10 into a high frequency and outputs the commercial power supply 10 in a pulsed manner at a continuous or predetermined duty, in order to rectify the input commercial power supply 10 into a direct current, and a rectifier circuit. A high frequency output circuit for converting the generated direct current into a high frequency and a modulation circuit for pulse-modulating the high frequency output circuit are provided. The output of the high frequency output circuit is adjusted by the output adjusting dial 19, and the output is designed to be in the range of 20 W to 800 W, preferably 30 W to 600 W.

[0023]

The electric scalpel of the present invention can be coagulated by inserting a tip into the abdominal cavity from a sleeve that penetrates the skin, sandwiching tissue, and energizing. Therefore, the electric scalpel of the present invention has a feature that it can be used for endoscopic surgery to pinch and coagulate a target tissue and effectively stop bleeding. Further, the tissue, nerves, muscles, etc. coagulated at the tip can be peeled off, and one scissor type electrode can be conveniently used for various purposes. Therefore, when the electric scalpel of the present invention is used, it is not necessary to replace various surgical instruments with and out of the sleeve, and the surgical time can be shortened and the burden on the patient can be reduced. In addition, the scissors can realize an easy-to-use feature due to the familiar shape of the operator. Furthermore, since the sliding portion of the scissors-type electrode is insulated by the sleeve, it is possible to prevent this portion from coming into contact with the skin of the patient and receiving an electric shock.

Further, the scissor-type electrode provided in the electric knife of the present invention can have a very narrow region at the tip as a non-insulating portion. For this reason, it is possible to accurately pinch the targeted local portion of the tissue, and at this time, it is possible to realize the feature that it is possible to prevent electricity from being applied to an extra portion of the tissue.

[Brief description of drawings]

FIG. 1 is a side view showing a conventional gripping forceps type electrode.

FIG. 2 is a plan view showing a tip portion of a grasping forceps type electrode.

FIG. 3 is a plan view showing a tip portion of a grasping forceps type electrode.

FIG. 4 is a schematic plan view showing an electric knife according to an embodiment of the present invention.

5 is a plan view of the scissors-type electrode of the electric knife shown in FIG.

6 is a side view showing a tip portion of the scissors-type electrode shown in FIG.

FIG. 7 is a cross-sectional view showing a tip portion of the scissors-type electrode shown in FIG.

FIG. 8 is a cross-sectional view showing a connection terminal of a scissor-type electrode.

FIG. 9 is a cross-sectional view showing a grip portion of the scissors-type electrode.

FIG. 10 is a graph showing the output waveform of the power supply.

[Explanation of symbols]

 1 ... Electrode 2 ... Pipe 3 ... Base 4 ... Clamping piece 5 ... Elastic rod 6 ... Shaft 7 ... Grip 8 ... Sleeve 9 ... Lead wire 10 ... Power supply 11 ... Pin 12 ... Insulation film 13 ... Grip 14 ... Non-insulation Part 15 ... Connection terminal 16 ... Insulation pipe 17 ... Arm 18 ... Mode change switch 19 ... Output adjustment dial

Claims (1)

[Claims] 1. A grasping forceps type electrode for energizing human tissue.
(1), a sleeve (8) having an inner diameter that allows the electrode (1) to be inserted therethrough, and a lead wire for the electrode (1).
In an electric knife comprising a power supply (10) connected via (9), the electrode (1) is a scissors type electrode, and the scissors type electrode (1) is connected to the tip end with a pin (11). The sliding part and the part other than the sliding part are covered with an insulating film (12), and the sleeve (8) is a cylindrically shaped insulating material. An electric knife characterized in that it is configured to be used by being insulated in 8).